How to Cope?

Nocturia — the need to get up frequently to urinate during the night — is a common cause of sleep loss, especially among older adults. It affects nearly two-thirds of adults ages 55 to 84 at least a few nights per week.

A mild case causes a person to wake up at least twice during the night; in severe cases, a person may get up as many as five or six times. Not surprisingly, this can lead to significant sleep deprivation and daytime fatigue.

Nocturia becomes more common with age. As we get older, our bodies produce less of an antidiuretic hormone that enables us to retain fluid. With lower concentrations of this hormone, we produce more urine at night. Also, the bladder tends to lose holding capacity as we age, and older people are more likely to suffer from medical problems that affect the bladder

 

Nocturia has numerous possible other causes, including disorders such as heart failure and diabetes, other medical conditions (urinary tract infection, enlarged prostate, liver failure, multiple sclerosis, sleep apnea) and medications (especially diuretics). Some cases are caused or exacerbated by excessive fluid intake after dinner, especially drinks containing alcohol or caffeine.

Therapies for nocturia fall into three categories: treatments to correct medical causes, behavioral interventions, and medication. The first step is to try to identify the cause and correct it. If this is unsuccessful, try behavioral approaches such as cutting down on how much you drink in the two hours before bedtime, especially caffeine and alcohol. If the nocturia persists, your doctor may prescribe one of a growing number of medications approved to treat an overactive bladder. The most commonly used is desmopressin (DDAVP, Stimate), which mimics some of the action of the antidiuretic hormone. If the problem stems from increased contractions of the bladder, relaxant agents such as tolterodine (Detrol) and oxybutynin (Ditropan) can be effective.